Association of AISI and SIRI levels with mortality risk in patients with type 2 diabetes: A retrospective cohort study

Inflammation plays a key role in complications and organ damage in type 2 diabetes mellitus (T2DM). The Aggregate Index of Systemic Inflammation (AISI) and Systemic Inflammation Response Index (SIRI) have emerged as potential markers for inflammation and prognosis. This study aimed to assess the association between AISI, SIRI levels, and mortality in T2DM patients. This study combined a population-level time-trend analysis using Global Burden of Disease data from 1990 to 2021 with a retrospective cohort study using National Health and Nutrition Examination Survey data from 1999 to 2018 linked to the National Death Index mortality files. The Global Burden of Disease data revealed an upward trend in T2DM incidence, with a slight decline in mortality rates from 2003 onward. In the National Health and Nutrition Examination Survey cohort, higher AISI and SIRI levels correlated with increased risks of cardiovascular disease (CVD) and all-cause mortality. After adjusting for confounders, the highest quartile of both indices (Q4) showed significantly higher mortality risks: for AISI quartile 4 (Q4) vs Q1, hazard ratio (HR) = 1.46 for CVD and HR = 1.71 for all-cause mortality; for SIRI Q4 vs Q1, HR = 1.98 for CVD and HR = 2.13 for all-cause mortality. These findings suggest AISI and SIRI may serve as simple markers for risk stratification in T2DM.